Increasing positive end-expiratory pressure (re-)improves intraoperative respiratory mechanics and lung ventilation after prone positioning

British Journal of Anaesthesia

Volumn 116, Issue 6, 2016, Pages 838-846

  Spaeth, J ^a   Daume, K ^a   Goebel, U ^a   Wirth, S ^a   Schumann, S ^a  

^a UNIVERSITY OF FREIBURG   (Germany)

Author keywords

artificial; circulatoryand respiratory physiological phenomena; lung; lung compliance; positive pressure respiration; posture; prone position; respiration; respiratory mechanics

Indexed keywords

ADULT; AGED; ARTICLE; BREATHING MECHANICS; CLINICAL ARTICLE; COMPUTER ASSISTED IMPEDANCE TOMOGRAPHY; CROSSOVER PROCEDURE; FEMALE; HUMAN; INTRAOPERATIVE PERIOD; LUMBAR SPINE; LUNG COMPLIANCE; LUNG VENTILATION; LUNG VOLUME; MALE; PATIENT POSITIONING; POSITIVE END EXPIRATORY PRESSURE; POSITIVE END EXPIRATORY PRESSURE VENTILATOR; PRIORITY JOURNAL; PROSPECTIVE STUDY; SPINE SURGERY; SUPINE POSITION; DIAGNOSTIC IMAGING; HEMODYNAMICS; IMPEDANCE; LUMBOSACRAL REGION; LUNG; MIDDLE AGED; PEROPERATIVE CARE; PROCEDURES; PRONE POSITION; SPINE; SURGERY; TOMOGRAPHY; VERY ELDERLY;

ADULT; AGED; AGED, 80 AND OVER; CROSS-OVER STUDIES; ELECTRIC IMPEDANCE; FEMALE; HEMODYNAMICS; HUMANS; INTRAOPERATIVE CARE; LUMBOSACRAL REGION; LUNG; LUNG COMPLIANCE; MALE; MIDDLE AGED; POSITIVE-PRESSURE RESPIRATION; PRONE POSITION; PROSPECTIVE STUDIES; PULMONARY VENTILATION; RESPIRATORY MECHANICS; SPINE; SUPINE POSITION; TOMOGRAPHY;

EID: 84973338581     PISSN: 00070912     EISSN: 14716771     Source Type: Journal    
DOI: 10.1093/bja/aew115     Document Type: Article

References (30)

1. Hedenstierna G. Small Tidal Volumes, Positive End-expiratory Pressure, and Lung Recruitment Maneuvers during Anesthesia: Good or Bad? Anesthesiology 2015; 123: 501-3
2. Spieth PM, Bluth T, Gama De Abreu M, Bacelis A, Goetz AE, Kiefmann R. Mechanotransduction in the lungs. Minerva Anestesiol 2014; 80: 933-41
3. Severgnini P, Selmo G, Lanza C, et al. Protective mechanical ventilation during general anesthesia for open abdominal surgery improves postoperative pulmonary function. Anesthesiology 2013; 118: 1307-21
4. Futier E, Constantin JM, Paugam-Burtz C, et al.Atrial of intraoperative low-tidal-volume ventilation in abdominal surgery. N Engl J Med 2013; 369: 428-37
5. Hemmes SN, Gama de Abreu M, Pelosi P, Schultz MJ, Anaesthesiology PNIftCTNotESo. High versus low positive end-expiratory pressure during general anaesthesia for open abdominal surgery (PROVHILO trial): a multicentre randomised controlled trial. Lancet 2014; 384: 495-503
6. Levin MA, McCormick PJ, Lin HM, Hosseinian L, Fischer GW. Low intraoperative tidal volume ventilation with minimal PEEP is associated with increased mortality. Br J Anaesth 2014; 113: 97-108
7. Weinstein JN, Lurie JD, Olson PR, Bronner KK, Fisher ES. United States' trends and regional variations in lumbar spine surgery: 1992-2003. Spine (Phila Pa 1976) 2006; 31: 2707-14
8. Pelosi P, Croci M, Calappi E, et al. The prone positioning during general anesthesia minimally affects respiratory mechanics while improving functional residual capacity and increasing oxygen tension. Anesth Analg 1995; 80: 955-60
9. Edgcombe H, Carter K, Yarrow S. Anaesthesia in the prone position. Br J Anaesth 2008; 100: 165-83
10. Gattinoni L, Caironi P. Prone positioning: beyond physiology. Anesthesiology 2010; 113: 1262-4
11. Wirth S, Baur M, Spaeth J, Guttmann J, Schumann S. Intraoperative positive end-expiratory pressure evaluation using the intratidal compliance-volume profile. Br J Anaesth 2015; 114: 483-90
12. Costa EL, Borges JB, Melo A, et al. Bedside estimation of recruitable alveolar collapse and hyperdistension by electrical impedance tomography. Intensive Care Med 2009; 35: 1132-7
13. Quanjer PH, Stanojevic S, Cole TJ, et al. Multi-ethnic reference values for spirometry for the 3-95-yr age range: the global lung function 2012 equations. Eur Respir J 2012; 40: 1324-43
14. Hemmerling TM, Le N. Brief review: Neuromuscular monitoring: an update for the clinician. Can J Anaesth 2007; 54: 58-72
15. Nowaczyk P, Murawa D, Połom K, et al. Analysis of sentinel lymph node biopsy results in colon cancer in regard of the anthropometric features of the population and body composition assessment formulas. Langenbecks Arch Surg 2012; 397: 779-86
16. Tusman G, Böhm SH, Vazquez de Anda GF, do Campo JL, Lachmann B. 'Alveolar recruitment strategy' improves arterial oxygenation during general anaesthesia. Br J Anaesth 1999; 82: 8-13
17. Mols G, Brandes I, Kessler V, et al. Volume-dependent compliance in ARDS: proposal of a new diagnostic concept. Intensive Care Med 1999; 25: 1084-91
18. Schumann S, Burcza B, Haberthur C, Lichtwarck-Aschoff M, Guttmann J. Estimating intratidal nonlinearity of respiratory system mechanics: a model study using the enhanced gliding-SLICE method. Physiol Meas 2009; 30: 1341-56
19. Lowhagen K, Lundin S, Stenqvist O. Regional intratidal gas distribution in acute lung injury and acute respiratory distress syndrome-assessed by electric impedance tomography. Minerva Anestesiol 2010; 76: 1024-35
20. Radke OC, Schneider T, Heller AR, Koch T. Spontaneous breathing during general anesthesia prevents the ventral redistribution of ventilation as detected by electrical impedance tomography: a randomized trial. Anesthesiology 2012; 116: 1227-34
21. Siegel S, Castellan NJ Jr. Nonparametric Statistics for the Behavioral Sciences. 2nd Edn. New York: McGraw Hill Book Company New York, 1988
22. Venegas JG, Harris RS, Simon BA. A comprehensive equation for the pulmonary pressure-volume curve. J Appl Physiol (1985) 1998; 84: 389-95
23. Palmon SC, Kirsch JR, Depper JA, Toung TJ. The effect of the prone position on pulmonary mechanics is frame-dependent. Anesth Analg 1998; 87: 1175-80
24. Hedenstierna G, Edmark L. The effects of anesthesia and muscle paralysis on the respiratory system. Intensive Care Med 2005; 31: 1327-35
25. Albert RK, Hubmayr RD. The prone position eliminates compression of the lungs by the heart. Am J Respir Crit Care Med 2000; 161: 1660-5
26. Tawhai MH, Nash MP, Lin CL, Hoffman EA. Supine and prone differences in regional lung density and pleural pressure gradients in the human lung with constant shape. J Appl Physiol (1985) 2009; 107: 912-20
27. Protti A, Andreis DT, Monti M, et al. Lung stress and strain during mechanical ventilation: any difference between statics and dynamics? Crit Care Med 2013; 41: 1046-55
28. Amato MB, Meade MO, Slutsky AS, et al. Driving pressure and survival in the acute respiratory distress syndrome. N Engl J Med 2015; 372: 747-55
29. Neumann P, Rothen HU, Berglund JE, Valtysson J, Magnusson A, Hedenstierna G. Positive end-expiratory pressure prevents atelectasis during general anaesthesia even in the presence of a high inspired oxygen concentration. Acta Anaesthesiol Scand 1999; 43: 295-301
30. Petersson J, Ax M, Frey J, Sánchez-Crespo A, Lindahl SG, Mure M. Positive end-expiratory pressure redistributes regional blood flow and ventilation differently in supine and prone humans. Anesthesiology 2010; 113: 1361-9